Addressing social determinants of health inequities through settings: a rapid review

Author version made available here in accordance with the publisher's policy.Changing settings to be more supportive of health and healthy choices is an optimum way to improve population health and health inequities. This paper uses the World Health Organisation’s (1998) definition of settings approaches to health promotion as those focused on modifying settings' structure and nature. A rapid literature review was undertaken in the period June-August 2014, combining a systematically conducted search of two major databases with targeted searches. The review focused on identifying what works in settings approaches to address the social determinants of health inequities, using Fair Foundations: the VicHealth framework for health equity (VicHealth 2013). This depicts the social determinants of health inequities as three layers of influence, and entry points for action to promote health equity. The evidence review identified work in twelve settings (cities; communities and neighbourhoods; educational; healthcare; online; faith-based; sports; workplaces; prisons; and nightlife, green and temporary settings), and work at the socioeconomic, political and cultural context layer of the Fair Foundations framework (governance, legislation, regulation and policy). It located a relatively small amount of evidence that settings themselves are being changed in ways which address the social determinants of health inequities. Rather, many initiatives focus on individual behaviour change within settings. There is considerable potential for health promotion professionals to focus settings work more upstream and so replace or integrate individual approaches with those addressing daily living conditions and higher level structures, and a significant need for programs to be evaluated for differential equity impacts and published to provide a more solid evidence base.This work was supported by the Victorian Health Promotion Foundation (VicHealth)

An Inquiry into Community Members’ Use and Attitudes toward Technology in Mishkeegogamang Tepacimowin Networks

Mishkeegogamang First Nation is a rural Ojibway community in Northwestern Ontario. Mishkeegogamang community members of all ages use a wide array of information and communication technologies (ICT) as tools in daily life, and as a means to support individual and community goals. This collaborative paper tells the story of how Mishkeegogamang uses ICT for community development, drawing on 17 interviews with community members, and several community member profiles. A basic descriptive quantitative analysis is also provided, giving information on frequency of use of a wide variety of technologies. Community informatics theory guides the interpretation of the findings. A broad range of ICT use by community members will be explored, including the Mishkeegogamang website, the busy yet invisible use of social networking sites, youth and ICT, ICT for health and education, and ICT to support traditional activities. Finally, a section on challenges and needs for facilitating ICT use is also provided. Mishkeegogamang has collaborated on a rich chronicle of its land and people in the Mishkeegogamang book: The Land, the People, and the Purpose (Heinrichs, Hiebert, & The People of Mishkeegogamang, 2009). This paper is conceptualised as a new chapter, documenting how community members use ICT in their daily lives and for community development. There have been no similar past explorations that have addressed this area. In addition, within the broader literature on First Nations in Canada, there have been few to no published accounts of community members’ perspectives and uses of ICT. This study is part of a broader collaborative research project called (First Nations Innovation), which explores how remote and rural First Nations are using information and communication technologies for community development